CT findings as predictive factors for treatment failure in Mycobacterium abscessus complex lung disease: a retrospective cohort study

• Published in: Japanese journal of radiology 2024-08, Vol.42 (8), p.852-861
• Main Authors: Chiang, Pin-Yi, Huang, Yu-Sen, Huang, Yu-Cheng, Lee, Ming-Yann, Kang, Victor Jing-Wei, Shu, Chin-Chung, Chang, Yeun-Chung
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Bronchiectasis; Bronchopneumonia; Cavitation; Cohort Studies; Consolidation; Correlation coefficient; Correlation coefficients; Diameters; Failure; Female; Health services; Humans; Imaging; Lung - diagnostic imaging; Lung diseases; Lung Diseases - diagnostic imaging; Lung Diseases - drug therapy; Lung Diseases - microbiology; Male; Medicine; Medicine & Public Health; Middle Aged; Mycobacterium abscessus; Mycobacterium Infections, Nontuberculous - diagnostic imaging; Mycobacterium Infections, Nontuberculous - drug therapy; Nodules; Nuclear Medicine; Original; Original Article; Predictive Value of Tests; Prognosis; Radiology; Radiotherapy; Regression analysis; Retrospective Studies; Tomography, X-Ray Computed - methods; Treatment Failure
• ISSN: 1867-1071; 1867-108X; 1867-108X
• DOI: 10.1007/s11604-024-01570-y

Purpose Mycobacterium abscessus complex (MABC) commonly causes lung disease (LD) and has a high treatment failure rate of around 50%. In this study, our objective is to investigate specific CT patterns for predicting treatment prognosis and monitoring treatment response, thus providing valuable insights for clinical physicians in the management of MABC-LD treatment. Methods We retrospectively assessed 34 patients with MABC-LD treated between January 2015 and December 2020. CT scores for bronchiectasis, cellular bronchiolitis, consolidation, cavities, and nodules were measured at initiation and after treatment. The ability of the CT scores to predict treatment outcomes was analyzed in logistic regression analyses. Results The CT scoring system had excellent inter-reader agreement (all intraclass correlation coefficients, > 0.82). The treatment failure (TF) group (17/34; 50%) had higher cavitation diameter ( p  = 0.049) and extension ( p  = 0.041) at initial CT and higher cavitation diameter ( p  = 0.049) and extension ( p  =0 .045), consolidation ( p  = 0.022), and total ( p  = 0.013) scores at follow-up CT than the treatment success (TS) group. The changes of total score and consolidation score ( p  = 0.049 and 0.024, respectively) increased in the TF group more than the TS group between the initial and follow-up CT. Multivariable logistic regression analysis showed initial cavitation extension, follow-up consolidation extension, and change in consolidation extension (adjusted odds ratio: 2.512, 2.495, and 9.094, respectively, per 1-point increase; all p